Good practice principles low rik drinking EU RARHA

sale of alcohol over the internet and mandatory age-check policies in alcohol outlets[ 2 ]. In some cases
in-country variation in age limits is a further factor undermining enforcement.
Harmful effects of alcohol for young people
Alcohol consumption in adolescence can have numerous negative short-term and long-term effects,
including social, physical, psychological and neurological consequences reaching into adult life.
Drinking to intoxication (binge drinking, heavy episodic drinking) is a common phenomenon in
youth cultures which poses severe health risks and can multiply negative short and long-term risks
especially for children and adolescents[ 3 ]. In connection with comorbid conditions like depression,
anxiety disorders or phobias, and traumatic events of life, heavy episodic drinking increases the risk of
suicide attempts and completed suicides[ 4 ]
In the ESPAD survey, a number of adverse short-term consequences of drinking have been
reported by the students, including individual problems (poor performance in school or academic
failure, accidents, injuries and hospital admittance), relationship problems, sexual problems (e.g.
unprotected sexual intercourse) and delinquency problems (fights, victimization by robbery and theft,
and trouble with the police).[ 5 ]
Traffic accidents are a major risk and a main cause of death for young people; a considerable share
of adolescents’ traffic accidents are connected to alcohol consumption[ 4 ]. Regular alcohol consumption
by young people often occurs together with other risk behaviours, such as use of tobacco or illicit drugs
and risky sexual behaviour. Early initiators, excessive drinkers and those engaging in multiple risk
behaviours are especially likely to experience adverse health outcomes[ 5 ].
Long-term consequences of alcohol consumption include harm to organs and nerve cells, brain
damage, liver cirrhosis and several types of cancer[ 6 ]. Young people are especially at risk for disruptions
of the brain development [ 7 , 8 ] particularly in the cortical region which influences cognitive, emotional
and social development [ 9 ]. Young people with alcohol use disorders may display structural and
functional deficits in brain development compared with non-alcohol-using peers. In addition, heavy
drinking during adolescence may affect normal brain functioning during adulthood[ 10 ].
Methodology
In Joint Action RARHA, work was carried out to form an overview of the existing guidelines for reducing
alcohol-related harm among young people in European countries, of the scientific background on the
long-term and short-term consequences of young people’s alcohol consumption, and of the attitudes
and opinions around this issue among European experts.
The first steps consisted in a review of relevant research literature and in a survey addressed to
members of the EU Committee on National Alcohol Policy and Action (CNAPA) and to experts
identified by them. The main purpose was to gather information on existing guidelines regarding young
people’s alcohol consumption in EU member states, Iceland, Norway and Switzerland. Information was
obtained from 27 countries.
To explore the extent of consensus in this area, a two-round Delphi survey was carried out with a
panel of close to 60 European experts on alcohol consumption and young people, engaged in research
or practical prevention, and identified by members of the CNAPA. The focus was on qualitative advice
for young people themselves, for parents and professionals and on strategies to minimize risk, rather
than on alcohol intake guidelines given in terms of standard drinks or units. Further topics addressed in
the Delphi survey concerned the experts’ views of priority areas of action and good practice measures
for reducing harm from alcohol for young people. Some positions or recommendations gained a fairly
broad consensus among the experts while views concerning other topics differed. A detailed account
on points of convergence and disagreement is presented in a comprehensive background paper[ 11 ].
Guidance on alcohol and young people in European countries
According to the survey carried out for RARHA, in 16 countries guidance regarding youth drinking have
been published independently, whereas in ten countries guidance has been issued as part of broader
national action plans or strategies. In most cases guidance was issued by governmental bodies,
scientific societies or medical associations. Less formal guidance provided by prevention centres or
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Good practice principles for low risk drinking guidelines